I’ve been putting off my visit to the endo’s office.
Not only because I don’t see the need to make any changes, but because I’ve been slacking off about keeping in touch with her and communicating about where I am in my diabetes management.
Really, I don’t see the need to go spend time (or co-pay) at a visit where I’m going to hear the scripted questions of “Why are you so high?” and “What’s standing in your way?”
Yes, I appreciate the discussion, and that she wants to know what’s up, how she can help…
But I know where I’m falling short. It’s more a matter of finding the motivation to do what’s needed, and I’m not going to
find that in a visit to the doctor.
So, just as Allison reported not long ago, I’m playing diabetes hookie. I’ve honestly just been avoiding the same old song and dance that leaves us tip-toeing around the edges of the dance floor without really knowing the steps.
This month’s DSMA Blog Carnival topic got me thinking about this, in which we were asked to explore a question from the May 30th session on “Tips & Tricks for Visiting Your Doctor.” Specifically, do we get nervous or stressed about having to go to the endo/doc appointment, and the reasons for that.
For the record: it’s not that I am nervous or stressed about going to see my endo. I just don’t see the point right now. What needs to happen has nothing to do with my endo or CDE — it’s all me.
My blood sugars aren’t in range — I know that just by looking at my meter. Hell, I don’t even have to look at my meter. Or my crazy glu-coaster CGM graphs. It’s clear how I’m doing. There’s nothing a doctor can say or do to motivate me or change my behavior, honestly. So let’s not waste each other’s time.
Thinking back, I have been nervous about appointments in the past and I probably will be again. I get nervous when I’m really trying hard on the D-management front and am highly anticipating my latest A1C result to somehow “justify” that I’ve been doing a “good” job (completely recognizing that I’m sidestepping the issue of A1C reliance and allowing numbers to define how I feel…).
What could my health care provider do to help patients like me feel more relaxed and comfortable? I don’t know, to tell you the truth.
Maybe nothing, since we’re talking about our own feelings on getting results handed to us. Nothing changes that.
Some say they need to make it less “scary,” or just “talk to us as people and not textbook patients.” Yes, I suppose those are important approaches, I’d agree.
Actually, one of the most creative ideas I’ve heard on this topic comes from Dr. Bill Polonsky of the Diabetes Behavioral Institute in San Diego, who mentioned at an ADA Scientific Sessions panel discussion recently that his clinic is now giving out stickers reminding people with diabetes that numbers aren’t statements of self-worth; the stickers say, “It’s Just A Number!” To me, that’s one of the best things any endo or CDE can do — remind us that it IS just a number, that the context is important, and it shouldn’t make us feel defeated or worthless.
Short of that, I think it comes down to each one of us individually to find whatever motivation we need to hit the endo’s office. Even if that means hearing what you’ve been trying to avoid. Bottom line is there’s no magic bullet; I guess you’ve got to make like Nike and “just do it.”
With that in mind, I need to schedule my appointment. It’s time to face the music and dance.
Note: This post is our entry in the June 2012 DSMA Blog Carnival. If you’d like to participate too, you can get all of the information you need right here.
I think one problem with having diabetes is that you have to take an “exam” every 4 months or so, and if the results aren’t good, you blame yourself.
Here’s another way of looking at it. Your A1c is 8. You haven’t failed. Your health care team has. They’re either prescribing the wrong treatment or they’ve failed to offer enough support to allow you to follow the prescribed treatment.
It’s hard enough to have diabetes. No one needs the guilt.
I wish more physicians were like Polansky.
In my brain I know it’s just a number. But my heart often sinks based on the value. It’s so hard, our lives are full of numbers. Let’s ignore the 6:00 AM on the clock, or the MPG, or distance traveled numbers. There’s the BG number, the carb count, the insulin units, the IOB, etc., etc.
I swear we should all have DN degrees, Diabetes Numerology!
Bernard’s comment is well-said: we’re told to use the numbers to make decisions (even when the readings are allowed to be +/1 25% during 95% of all tests, thanks FDA!) but they aren’t reflections of our self-worth. Yet who among us doesn’t self-depreciate at the sight of a number that’s not perfect? The question I have is why the heck are doctors always so perplexed by the fact that depression is higher among people with diabetes. They conclude (often incorrectly) that it is a function of glycemic control, rather than the chronic treatment protocol that they’ve just handed to patients!
My doctor told me I had better be compliant, because he gets a “grade”. The nerve. I haven’t been back in over a year, and if I didn’t a prescription for insulin and the doc’s signature to drive a motor vehicle, I wouldn’t be going at all. (And my A1c’s are fine. Thanks, Reli-On.)
*NEED a prescription. Where’s the edit button?
This is an issue I’ve been thinking /feeling about for a while now. There’s a mind/body split going on here keeps a lot of our internal resources for dealing with this complex illness sadly under-used and brushed aside
These numbers are merely a reflection of some very complex processes that are going on, within us –in our bodies. And our bodies are the source of how we feel—tired, energetic, depressed, happy. If we’re sensitive to our internal world, there’s a lot there that can actually help us to deal with the moment to moment challenges of diabetes.
But instead, we’re encouraged to look at it all from the outside, as if we were scientists analyzing data
When we focus on only the numbers and ignore how we feel (or don’t connect the numbers to how we feel) we are disembodying ourselves and our relationship to what the numbers are actually pointing to
There’s a tendency to see the whole project as a “war” and nothing more: me vs. my diabetes
…and since the diabetes is intimately associated with all the processes of my body, it becomes “me (my mind) vs. me (my body)”
me vs. me, basically.
We’re also passing up a lot of information that can help us to get better numbers
We could be developing techniques and habits that enable us to trust our own intuition in the moment and make the best possible decisions, using the analysis of numbers in a more integrated way along with all the other perspectives available to help us,
and we could be working on accept ourselves in ways that make it easier to muster together the internal resources to really take care of ourselves
Jay
I do what you do when I feel the same way so I completely understand. I mean 99.9% of the time the issue is “me” so…I mostly go to the endo just for the A1c test. BUT, it has helped me lately with this new endo I’ve had for the past 2 years-he is really funny and never says anything to me with a straight face. So he looks at some of my highs and cracks jokes like, “wow, look at this 300, your kids were driving you nuts here, right?” Basically, he knows how to make me feel at ease and he knows that SO many things can contribute to off blood sugars. So he focuses the visit on asking me how I feel and then he listens. I wish more endos did that.
I know where you are coming from, Mike. It’s hard when we hit a patch of burnout and the reality is we need to motivate ourselves out of it before our health care team can really help us. I think deciding that it’s time to get that appointment scheduled is a great first step, so yay for you!!! I also love any post with a reference from Dr. Polonsky. He’s awesome!!
Really, the only reason I go to the endo is for my A1C. Sometimes small changes are made to basal and bolus, but it generally is my motivation to get things done that needs to change.
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